My back hurts: Now what?
12/1/2022 by Denise Dupras, M.D., Ph.D.
If your back hurts, you're not alone. Back pain is one of the most common complaints and reasons patients seek medical attention. It's estimated that 80% of adults have back pain at some point in their lives. At any one time, up to 40% may be experiencing pain. But when is it serious, and when should you see a doctor?
Acute back pain
Acute back pain lasts less than four weeks. There are many causes, which include:
- Sprains and strains, which are the most common cause.
- Degeneration of the discs between the bones of the spine or vertebra.
- Herniated or ruptured discs that can cause pain, as well as compress spinal nerves, leading to pain going into your legs, sometimes called sciatica.
- Spinal stenosis, or narrowing of the channel for the spinal cord.
- Irregularities of the spine, including scoliosis, or a sideways curve of the spine, and spondylolisthesis, which is overlapping of the vertebra.
When to seek medical attention
While most acute back pain goes away, sometimes it's due to a serious condition. In these cases, you should seek medical attention. Signs or symptoms associated with the sudden onset of back pain that indicate something serious might be going on include:
- Inability to control your bowel or bladder.
- Loss of strength or sensation in your legs.
- Daily use of prednisone.
- History of cancer, spine infection, osteoporosis or aortic aneurysm.
What to expect at your appointment
If you do seek medical attention, here's what you can expect at your appointment:
- Your clinician will ask you questions about your past medical health, medications, activities and your current symptoms.
- A physical examination will assess your muscle strength and nervous-system function. Depending on these findings, laboratory testing and imaging may be ordered.
- Not everyone who has back pain needs X-rays of their back, and very few people need other studies, such as a CT scan, MRI or electromyography (EMG), a diagnostic procedure to assess the health of muscles and the nerve cells that control them.
Denise Dupras, M.D., Ph.D., is a physician in Community Internal Medicine, Geriatrics and Palliative Care at Mayo Clinic in Rochester. She earned her medical and doctoral degrees at Mayo Clinic Alix School of Medicine and completed her residency in internal medicine at Mayo Clinic in Rochester. Her interests include medical education, evidence-based medicine and care of LGBTQIA+ patients.